Home monitoring improves blood pressure control, study finds

The use of at-home blood pressure monitors and Web-based reporting tools that connect clinicians and patients via the Internet appears to significantly improve patients' ability to manage their hypertension to healthy levels, according to a recent study from Kaiser Permanente presented at the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke meeting of the American Heart Association (AHA).

The six-month study, led by Kaiser Permanente Colorado in collaboration with the AHA and Microsoft Corp., involved 348 patients, aged 18 to 85 years, with uncontrolled hypertension.

"While more research is necessary, our study suggests that using technology to engage individuals in their care at home may be a better way to help patients achieve a healthy blood pressure," says lead author David Magid, MD, Kaiser Permanente senior scientist.

Earlier research by Magid found that when patients used home monitoring but were required to write down and call in their results, blood pressure goals improved only slightly. This latest study aimed to provide an additional layer of automation and convenience by directly feeding the readings from the home blood pressure cuff to the patient's care team.

In the latest study, participants were randomly assigned to a group receiving usual care or a group for which care included home monitoring. Hypertension in the usual care group was managed in a typical model that involved checking blood pressure during office visits.

Members of the home monitoring group used an at-home blood pressure device that uploaded data to the patient's account in a security enhanced, Web-based data storage platform. A Kaiser Permanente application automatically transferred the home blood pressure readings to Kaiser Permanente's electronic disease registry. The health system's clinical pharmacists used the computerized registry to monitor readings and consulted with patients to adjust their antihypertensive medications based on proven protocols. Connected to the data storage platform, patients were able to manage their data using a free online tool provided by the AHA.

At the start of the study, the average systolic blood pressure was 149 mm Hg in the home monitoring group and 145 mm Hg in the usual care group. At six months, patients in the home monitoring group were 50 percent more likely to have their blood pressure controlled to healthy levels compared with those in the usual care group. Similarly, a significantly greater decrease in systolic blood pressure at six months occurred in those the home monitoring group (Ð21 mm Hg) versus those in the usual care group (Ð9 mm Hg).